HomeMy WebLinkAboutStreet Cut Permits 216 Skyline Drive (2) 1300034 TOWN OF SOUTH WINDSOR, CT
PERMIT NUMBER STREET CUT PERMIT
//
DATE: 04/04/2013
GIS ID: 83100216 25.00
MUNIS APPLICATION# 201300367
j
— FEE:
y
PIRATION DATE: 04/04/2014
�� A
APPLICANT' ,
LOCATION
NAME: ADVANCED CONSTR JCTI0 1 �DDRES 1 KV-LINE DRIVE
ADDRESS: 5 CHESTNUT HILL RJ1 - j� EWE S�WKAyALEX J&CATHERINE A
STAFFORD, CT 0607 �' ' �
% Tt!9k1 ,INE DRIVE
s %� �TT-H*INDSOR, CT 06074
jj
PHONE 860-519-8442 = ---
- �i % ,
WORK DESCRIPTION: INST1_ P , Ej_,
APPLICANT AGREES TO FURNISH THE W�1 SQU I ITMQ BOND REQUIRED AND TO REIMBURSE
THE TOWN OF SOUTH WINDSOR FOR ANC E 'E it ._ NV-0 MAINTENANCE OR REPAIR WORK IN
CONNECTION WITH THIS PERMIT AND T- uc) T IS W A *WE ABIDE BY THE RULES AND REGULATIONS
FOR PERMITS AS OUTLINED IN THE TOWN 0Pb%'O" L VI -PEIMYTMANUAL.
C v e =- '
ISSUED BY DA" ED INSPECTED BY
4/4/2013 11:09 AM *** PERMIT TO BE KEPT ON JOB SITE AT ALL TIMES***
- -.... - .... -------------
WIN
ZZ
y M
s
- ff
ap
it
i
i
i --
AW
-
NO; j
-0 - %
TOWN OF SOUTH WINDSOR INSPECTION REPORT
PERMIT NO.: 130663 `( CONTRACTOR: Ad va otpd Cv pl +k_
LOCATION:
TYPE OF WORK: Y I
DATE INSP NEEDED: DATE INSP:
INSPECTED BY:
WORK IN
PROGRESS:
SEPTIC TANK PUMPED, SMASHED, FILLED WITNESSED ❑ YES ❑ NO
AS-BUILT:
INPUT: C I/ \. DATE:
S/FORMS/TOWN OF SOUTH WINDSOR INSPECTION
APPLICATION FOR STREET EXCAVATION PERMIT _
Appl. No. TOWN OF SOUTH WINDSOR Permit No.
PUBLIC WORKS DEPARTMENT
1540 SULLIVAN AVENUE Date:
SOUTH WINDSOR, CT 06074
FEE�j$25.00 cp Name of Firm �y(��\ l� ( U11�1, ��C�` L��� `�� Phone No.c LO
Address of Firm S 0A-P`_i 1(W T I-O LL �?b0,,C j (�(�� Zip Code O
Location of proposed work
Describe fully nature of permit requested 1 V}
,216 S K4 J h e-- O)-
Starting date Approx. time for completion
Call Before You Dig No. Existing Water Supply: ETFublic Water ❑ Well
Existing Sewage Service: ❑ Public Sewer ❑ Septic
PLEASE NOTE: THE DEPOSIT FOR THE PERMANENT PAVEMENT PATCH AND CURB REPLACEMENT IS A
PRELIMINARY ESTIMATE. THE APPLICANT IS RESPONSIBLE FOR THE FULL FINAL COST OF THE
PERMANENT PATCH AND CURB REPLACEMENT, INCLUDING ANY INCREASES IN PATCH AREA, CURB
LENGTH,TRAFFIC CONTROL AND THE TOWN'S CONTRACT COSTS. THE PERMANENT PATCH IS TYPICALLY
COMPLETED WITHIN A YEAR OF THE TEMPORARY PATCH BUT IT COULD BE LATER THAN A YEAR.
Show sketch of proposed work or furnish This section to be filled out by
two copies of separate drawing Indicate North Town of South Windsor
No. cuts
0
Est. Patch Size(s)_ ___—____sf
Est. Pvt. Thickness in.
/1 Est. Patch Unit Price$_`—_—_/sf
(� Est. Patch Cost
Est. Curb Replacement _ It
Est. Curb Unit Price$ /ft
Est. Curb Cost$
Est. Traffic Unit Cost$ /hr
Est.Traffic Control-----------------
$_ _
1 Amt.of Deposit$^_ _
t�
Total Due$
( ) Cash ( ) Check it
Applicant i i e for contacting Paid
the Police Dept. and C.B.Y.D. ----�
I AGREE TO FURNISH TO THE TOWN OF SOUTH WINDSOR THE AMOUNT OF BOND REQUIRED AND TO REIMBURSE THE
TOWN OF SOUTH WINDSOR FOR ANY EXPENSES INCURRED BY THE TOWN FOR MAINTENANCE OR REPAIR WORK IN
CONNEC WITH THIS PERMIT AND THAT I AM FAMILIAR WITH AND WILL ABIDE BY THE RULES AND REGULATIONS FOR
PERMI AS 0 TLINED IN THE TOWN OF SOUTH WINDSOR'S STREET CUT PERMIT MANUAL.
Signed: Date: / 0 2 01
Title: Driver's License
PLEASE ALLOW AT LEAST TWO WORKING DAYS AFTER APPLICATION FOR ISSUANCE OF PERMIT
WORK MAY NOT BEGIN UNTIL A PERMIT HAS BEEN ISSUED
PERMIT SHALL BE KEPT ON JOBSITE AT ALL TIMES